Individual
ETHAN POWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
710 S PAULINA ST STE 438, CHICAGO, IL 60612-3808
(312) 563-2330
Mailing address
710 S PAULINA ST STE 438, CHICAGO, IL 60612-3808
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149020350
IL
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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